Active NPI
Min Shin
- General Practice Dentistry
- Raleigh, NC
National Provider Identifier
1669894010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9651
- Practice address
- 5443 Wade Park Blvd
#1315
Raleigh, NC 27607-6053 - Phone
- (919) 360-0027
- NPI assigned
- Jan 18, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9651 | NC | Primary |
Addresses
Primary practice location
5443 Wade Park Blvd
#1315
Raleigh, NC 27607-6053
Mailing address
12 N Broad St E
Suite 101
Angier, NC 27501-8964
Phone (919) 639-2663
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9651 | NC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390003200000",
"number": "1669894010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 N BROAD ST E",
"address_2": "SUITE 101",
"city": "ANGIER",
"state": "NC",
"postal_code": "275018964",
"telephone_number": "919-639-2663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5443 WADE PARK BLVD",
"address_2": "#1315",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276076053",
"telephone_number": "919-360-0027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "MIN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-18",
"last_updated": "2014-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "9651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.